One risk factor is worth calling out on its own: smoking. An aortic dissection often starts with a weakened aorta, and one of the most common causes of that weakness is an abdominal aortic aneurysm — a bulge in the aortic wall that can develop silently over years. The U.S. Preventive Services Task Force recommends a one-time abdominal ultrasound to screen for this in men aged 65 to 75 who have ever smoked at least 100 cigarettes in their lifetime (a Grade B recommendation). Men in that age range who've never smoked should talk with their doctor about whether screening makes sense based on family history and other risk factors. It's a simple, painless test, and it's the kind of screening that's easy to overlook until something goes wrong.

The hallmark symptom is sudden, severe chest or upper back pain — often described as tearing or ripping — that may move as the dissection extends. Other possible symptoms include sudden severe abdominal pain, fainting or loss of consciousness, weakness or numbness on one side of the body (which can mimic a stroke), shortness of breath, and a noticeably weaker pulse in one arm compared to the other.
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​Because these symptoms can look like a heart attack or stroke, aortic dissection is sometimes missed early on. If you or someone near you has sudden, severe chest or back pain — especially pain that feels like tearing — treat it as a medical emergency and call 911.

Aortic dissection is uncommon, but it's serious, and blood pressure control is the most modifiable risk factor we have. If you have high blood pressure, especially with a family history of aortic or heart disease, it's worth asking your doctor whether it's well controlled and whether any additional evaluation of your heart or aorta makes sense.
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​This post is for general education and isn't a substitute for care from your own physician. If something feels seriously wrong with your body, don't wait to find out why — seek care right away.